Clin Epidemiol. 2017 Dec 15;9:699-719. doi: 10.2147/CLEP.S146496. eCollection 2017.
Association between coffee or caffeine consumption and fecundity and fertility: a systematic review and dose-response meta-analysis.
Clinical epidemiology
Julie Lyngsø, Cecilia Høst Ramlau-Hansen, Bjørn Bay, Hans Jakob Ingerslev, Adam Hulman, Ulrik Schiøler Kesmodel
Affiliations
Affiliations
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus.
- The Fertility Clinic, Regional Horsens Hospital, Horsens.
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus.
- Danish Diabetes Academy, Odense.
- Department of Obstetrics and Gynaecology, Herlev and Gentofte Hospital, Herlev, Denmark.
PMID: 29276412
PMCID: PMC5733907 DOI: 10.2147/CLEP.S146496
Abstract
OBJECTIVE: The aim was to investigate whether coffee or caffeine consumption is associated with reproductive endpoints among women with natural fertility (ie, time to pregnancy [TTP] and spontaneous abortion [SAB]) and among women in fertility treatment (ie, clinical pregnancy rate or live birth rate).
DESIGN: This study was a systematic review and dose-response meta-analysis including data from case-control and cohort studies.
METHODS: An extensive literature search was conducted in MEDLINE and Embase, with no time and language restrictions. Also, reference lists were searched manually. Two independent reviewers assessed the manuscript quality using the Newcastle-Ottawa Scale (NOS). A two-stage dose-response meta-analysis was applied to assess a potential association between coffee/caffeine consumption and the outcomes: TTP, SAB, clinical pregnancy, and live birth. Heterogeneity between studies was assessed using Cochrane
RESULTS: The pooled results showed that coffee/caffeine consumption is associated with a significantly increased risk of SAB for 300 mg caffeine/day (relative risk [RR]: 1.37, 95% confidence interval [95% CI]: 1.19; 1.57) and for 600 mg caffeine/day (RR: 2.32, 95% CI: 1.62; 3.31). No association was found between coffee/caffeine consumption and outcomes of fertility treatment (based on two studies). No clear association was found between exposure to coffee/caffeine and natural fertility as measured by fecundability odds ratio (based on three studies) or waiting TTP (based on two studies).
CONCLUSION: Results from this meta-analysis support the growing evidence of an association between coffee/caffeine intake and the risk of SAB. However, viewing the reproductive capacity in a broader perspective, there seems to be little, if any, association between coffee/caffeine consumption and fecundity. In general, results from this study are supportive of a precautionary principle advised by health organizations such as European Food Safety Authority (EFSA) and World Health Organization (WHO), although the advised limit of a maximum of two to three cups of coffee/200-300 mg caffeine per day may be too high.
Keywords: assisted reproduction; caffeine; coffee; fecundity; fertility; spontaneous abortion
Conflict of interest statement
Disclosure The authors report no conflicts of interest in this work.
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